Surgical Outcomes of Gastrectomy for Elderly Patients with Gastric Cancer

Background

This study was designed to determine the surgical outcomes of gastric cancer in elderly patients. This information can help establish appropriate treatment for these patients.

Methods

A total of 1,193 patients with gastric cancer who underwent gastrectomy between 1995 and 2010 were enrolled in this retrospective study. The clinicopathologic features of 104 elderly patients (aged ≥80 years) were compared with those of 1,089 nonelderly patients.

Results

(1) Tumors located in the lower-third of the stomach, differentiated cancer, and surgery with limited lymph node dissection were more common in elderly patients. However, there was no difference in the proportion of laparoscopic gastrectomy between elderly and nonelderly patients. (2) Although surgical complication rates were similar in the two groups, the operative mortality rate was higher in elderly patients (1.9 %) than in nonelderly patients (0.7 %). (3) Elderly patients had a significantly poorer overall survival rate, whereas the disease-specific survival rates of the two groups were similar. Limited lymph node dissection did not influence the disease-specific survival rate of elderly patients. (4) The median life expectancy of elderly gastric cancer survivors was 9.8 years in patients aged 80–84 years and 6.0 years in those ≥85 years. The patients with limited lymph node dissection had slightly better prognosis.

Conclusions

The treatment results in elderly patients were comparable to those in nonelderly patients. These findings suggest that R0 resection with at least limited lymph node dissection according to Japanese guidelines should be considered, even for elderly patients.     

Early abnormality detected by speckle-tracking echocardiography in a patient with suspected cardiac sarcoidosis

A 56-year-old female was admitted to our hospital because of respiratory symptoms. Her admission ECG showed normal sinus rhythm and standard echocardiographic evaluation showed no structural or functional abnormalities. She was diagnosed as having sarcoidosis by imaging modalities and mediastinum lymph node biopsy. In this case, 2-dimensional speckle-tracking echocardiography (STE) demonstrated abnormal regional myocardial function and delayed enhancement cardiac magnetic resonance imaging revealed a high intensity area in the same segments. This case suggests that STE is potentially useful for the detection of cardiac sarcoidosis in the early phase.     

Morphology of the olivocerebellar projection of the chick: An axonal reconstruction study

The projection pattern of the olivocerebellar (OC) axons, which terminate mainly as climbing fibers (CFs) in the cerebellar cortex, tightly reflects the compartmental and developmental organization of the cerebellum as revealed by mapping and reconstruction studies in the rat. The avian cerebellum is well lobulated and longitudinally compartmentalized like the mammalian cerebellum. However, the projection pattern of the OC axons has not been studied in detail for most areas of the avian cerebellum. In the present study, we reconstructed labeled chick OC axons resulting from a small focal injection of biotinylated dextran amine into the inferior olive to investigate their morphological characteristics, and to determine their relationship to the general morphology of the chick cerebellum. Labeled CFs were distributed basically in a single longitudinally elongated narrow band‐shaped area in lobules I–VIII, but in multiple, transversely widened, band‐shaped areas in lobules IX–X. Three of the four reconstructed OC axons terminated in a single longitudinally band‐shaped area in lobules IXa–c, whereas the other one terminated in multiple mediolaterally separated areas in lobule IXc, which is part of the flocculus. Single OC axons branched into 14 CFs on average. Two CFs occasionally merged to form a single terminal arbor. Axons also had thin, non‐CF collaterals that projected either to a cerebellar nucleus or to the cortex. The results indicate that the morphological characteristics of OC axons, including branching and termination, are basically conserved between the chick and the rat. J. Comp. Neurol. 521:3321–3339, 2013. © 2013 Wiley Periodicals, Inc.     

Examination of bond strength and mechanical properties of Y-TZP zirconia ceramics with different surface modifications

The purpose of our study was to evaluate the effects of surface modifications on the bond strength between veneering porcelains and Yttria-stabilized tetragonal zirconia (Y-TZP). In a bond strength tests, the effect of control, 70 μm alumina-sandblasting, 30 μm and 110 μm silica-coating of the Y-TZP surface on bonding were evaluated with veneering porcelains. In addition, the effect of surface modification on the flexural strength of Y-TZP was also evaluated. The data was analyzed using one-way ANOVA and Tukey test. All specimens showed bond strength values in excess of 25 MPa, the minimum allowed by ISO9693. In addition, significantly differences were found between the control and the 30 μm silica-coated. On the other hand the flexural strength of Y-TZP does not significantly difference for any surface modification. These results indicate that silica-coating may provide an effective pre-treatment for this enhancement of the bond strength while maintaining the strength of Y-TZP.     

Fundamental study of radiogallium-labeled aspartic acid peptides introducing octreotate derivatives

Annals of Nuclear Medicine - Somatostatin receptors are highly expressed in neuroendocrine tumors, and many radiolabeled somatostatin analogs for diagnosis and treatment have been developed. To...     

Review of Cognitive Characteristics of Autism Spectrum Disorder Using Performance on Six Subtests on Four Versions of the Wechsler Intelligence Scale for Children

Journal of Autism and Developmental Disorders - This study was a systematic review of research using the Wechsler Intelligence Scale for Children (WISC) with Autism Spectrum Disorder (ASD) to...     

SUV<Subscript>max</Subscript> on FDG-PET is a predictor of prognosis in patients with maxillary sinus cancer

Purpose

Our aim was to determine whether the maximum standardized uptake value (SUV_max) of the primary lesion demonstrated by [¹⁸F]-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is associated with the prognosis of maxillary sinus cancer.

Materials and methods

The relationships of clinicopathological factors including age, T stage, N stage, histologic type, treatment strategy, and primary tumor SUV_max with progression-free (PFS) and overall (OS) survival were evaluated using the log-rank test and Cox method in 31 patients with maxillary sinus cancer before combined superselective intra-arterial chemotherapy using high-dose cisplatin with concurrent radiotherapy, or radiotherapy alone.

Results

The median duration of follow-up was 55.4 (range 9.7–72.6) months. PFS and OS of patients exhibiting a high SUV_max (≥16 and ≥17, respectively) for the primary tumor were significantly lower than those of patients for whom the primary tumor SUV_max was low (p = 0.0010 and p = 0.033, respectively). Multivariate analyses showed that T stage (p = 0.0049) and primary tumor SUV_max (p = 0.026) were independently prognostic of poorer PFS and that only primary tumor SUV_max (p = 0.049) was independently prognostic of poorer OS.

Conclusion

SUV_max of the primary tumor determined by FDG-PET/CT before treatment could be a good surrogate marker for prognostication of maxillary sinus cancer.

     

Risk Factors for Early Recurrence of Single Lesion Hepatocellular Carcinoma After Curative Resection

Background and objectives

Hepatic resection is established as the treatment for HCC. However, patients sometimes experience early recurrence of HCC (ER HCC) after curative resection.

Methods

A retrospective analysis was conducted for 193 patients with single HCC who underwent curative liver resection in our medical center between April 2000 and March 2013. We divided the cohort into two groups; early recurrence group (ER G) which experienced recurrence within 6 months after resection, and non-early recurrence group (NER G). Risk factors for ER HCC were analyzed.

Results

Thirty-nine out of 193 (20.2 %) patients had ER HCC. Univariate analysis showed Glasgow prognostic score (GPS, p = 0.036), neutrophil to lymphocyte ratio (NLR, p = 0.001), level of PIVKA-II (p = 0.0001), level of AFP (p = 0.0001), amounts of blood loss (p = 0.001), operating time (p = 0.002), tumor size (p = 0.0001), stage III and IV (p = 0.0001), and microvascular invasions (portal vein: p = 0.0001 and hepatic vein: p = 0.001) to be associated with ER HCC. By multivariate analysis, there were significant differences in high NLR (p = 0.029) and high AFP (p = 0.0001) in patients with ER HCC.

Conclusions

Preoperative high AFP (more than 250 ng/ml) and high NLR (more than 1.829) were independent risk factors for ER HCC.